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A West Health-Gallup survey out Tuesday found that millions of Americans are borrowing significant amounts of money to pay for healthcare, with an estimated total of $88 billion borrowed to pay for care in the last year.

The survey of more than 3,300 U.S. adults found that one in eight had borrowed money to pay for healthcare. Nearly 3 million people have borrowed more than $10,000 to pay for care, they found, and “65 million adults had a health issue but did not seek treatment due to costs in the past 12 months.” More frightening still, 41 percent reported forgoing emergency room care because of the cost.

Gallup senior researcher Dan Witters told CNN the report shows there are “few Americans out there who are safe from the American health care cost crisis.”

The survey also asked respondents whether they would prefer a pay raise of 10 percent or a freeze in healthcare costs over the next five years. Across all income groups, a majority favored the freeze in health costs. Among the lowest income group earning less than $24,000 a year, 67 percent favored a freeze in health costs over earning more money. Among that income group, 45 percent said cost was “extremely important” when considering a recommended procedure or medicine from their doctor, and 40 percent of those earning between $24,000 and $48,000 said the same.

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This means we have a situation where almost half of people who don’t earn a lot—the median household income in the U.S. is around $61,000—feel unable to simply accept what their doctor recommends is best because of how much it’ll cost.

Over four million Americans, the report found, have borrowed at least $5,000 to pay for healthcare.

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None of this should be our reality. No one should have to borrow money for medical care; no one should have to ignore their doctor’s orders because they can’t afford the drug or the treatment; no one should feel unable to go to the emergency room because they might not be able to afford it. This is what for-profit healthcare looks like, and it must be destroyed.